We randomly assigned 4589 healthy nulliparous women who were 13 to 21 weeks pregnant to receive daily treatment with either 2g of elemental calcium or placebo for the remainder of their pregnancies. Calcium supplementation did not significantly reduce the incidence or severity of preeclampsia or delay its onset. Additional analyses utilizing the study database and specimen repository are being performed. During FY04 papers were published on circulating angiogenic factors and the risk of preeclampsia and on cell-free fetal DNA and C-reactive protein in preeclampsia. Manuscripts on glucose tolerance, gestational diabetes, and smoking and on pregnancy outcomes in smokers who develop preeclampsia are in press and others on urinary insulin in preeclampsia and gestational hypertension and on urinary placental growth factor in preeclampsia have been submitted for publication. Several important large studies on angiogenic factors in preeclampsia, gestational hypertension, and intrauterine growth restriction are underway.